Have you recently noticed a new bruise on your arm but have no recollection of injuring yourself? Bruising is a fairly common occurrence for everyone (not just the clumsy!) and it resolves itself easily enough. However, constant bruising for no apparent reason or bruises that take a significant amount of time to fade should can be alarming.

Let us start by understanding what bruising really is and how it occurs. When you injure yourself, a blood vessel beneath your skin might rupture, releasing blood into the extravascular space — the space outside blood vessels. The collection of blood beneath your skin then gives the characteristic purple or red colour in a bruise. Overtime, the blood beneath your skin undergoes a series of chemical reactions and gets cleared, allowing the bruise to resolve.

Normally, people do not bruise spontaneously because our bodies are in balance— a state known as homeostasis. In the case of bleeding, balance is regulated by clotting and anti-clotting factors produced by our bodies. The former stops bleeding while the latter promotes bleeding. A disturbance of this physiological balance—such as a decrease in clotting factors — can cause bleeding disorders. So, when might such imbalances occur?

Ageing

It is no surprise that the human skin thins as we age, causing it to be less effective as a protective barrier. Thus, the elderly population is often more prone to bruising, even after light knocks. Consistent use of moisturisers and sunblock, as well as nutritious diets rich in vitamin C can protect against easy bruising in this age group.

Medication

Some medications “paralyse” the natural clotting factors produced by our bodies, causing us to be at higher risk of bruising. These include non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, as well as blood thinners like warfarin. However, if these drugs are taken within their prescribed ranges, the risk of bruising is likely to be low. If you happen to be on such drugs and are currently facing the issue of bruising, do check with your doctor for advice.

Genetic diseases

Some patients might inherit a condition where they have a deficiency of natural coagulating factors, thus causing them to have higher bleeding tendencies. Such diseases have various presentations; symptoms are more likely to manifest during childhood if the condition is severe enough.

Other diseases

Many already know about the benefits of vitamin C, but few know about the importance of vitamin K. Vitamin K is essential to activate various clotting factors; without it, our inactive clotting factors will not be able to do their job in preventing bleeds. Most of our regular diets already include foods rich in vitamin K— such as leafy vegetables, fish and eggs. As such, vitamin K deficiency is quite unlikely with adults. Most of the time, patients diagnosed with vitamin K deficiency suffer from gastrointestinal issues which prevent proper absorption of the vitamin. Our various body systems constantly interact with one another, and a disorder in one body system can often present itself as symptoms in another system.

Spontaneous bleeding can be worrying and might be an additional cause of stress. There are many reasons for it, ranging from a mere lack of nutrients to severe genetic diseases. When in doubt, always check with your family doctor for advice and support.